Transmitted Drug Resistance Among Recently Diagnosed Adults and Children in Sao Paulo, Brazil

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de Souza Guimaraes, Paula Morena ; de Paula Ferreira, Joao Leandro ; Ozorio Coelho, Luana Portes ; Cavalcanti, Jaqueline de Souza ; Silva Lopez Lopes, Giselle Ibette ; Matsuda, Elaine Monteiro ; Almeida, Flavia Jacqueline ; Almeida, Valeria Correia ; Campeas, Alexandre Ely ; Pereira Junior, Luiz Carlos ; de Macedo Brigido, Luis Fernando ; Sao Paulo Salvage Workgrp

• Document type: Journal article
• Source: AIDS Research and Human Retroviruses; v. 31, n. 12, p. 6-pg., 2015-12-01.

Abstract

Transmitted drug resistance mutations (TDRM) have been a constant threat to treatment efficacy. We evaluated TDRM in plasma RNA of 217 antiretroviral therapy-naive patients from sites in the SAo Paulo metropolitan area, collected from 2012 to 2014. The partial HIV-1 polymerase region was sequenced using Big Dye terminators at an ABI 3130 Genetic Analyzer. TDRM was defined according to the Stanford database calibrated population resistance (CPR v.6.0), but other drug resistance mutations (DRM) considered at the IAS list (IAS, 2014) and at the Stanford HIV Database Genotyping Resistance Interpretation (GRI-HIVdb) were also described. Out of 78% (170/217) of patients with information on the time of diagnosis, most (83%, 141/170) had been recently diagnosed, with the first positive HIV serology at a median of 58 days (IQR 18-184). Subtype B predominated (70%), followed by subtype F (10%), BF (7.5%), C (7.5%), and BC (5%). TDRMs were observed in 9.2% (20/217, CI 95% 5.9% to 13.6%), mostly (5.2%) to nonnucleoside reverse transcriptase inhibitor (NNRTI) antiretroviral class. Among children and adolescents, only a single patient showed TDRMs. Additional non-CPR mutations were observed: 11.5% (25/217) according to IAS or 4.6% (10/217) according to GRI-HIVdb. Overall, 23.5% (51/217) of the cases had one or more DRM identified. TDRM prevalence differed significantly among some sites. These trends deserve continuous and systematic surveillance, especially with the new policies of treatment as prevention being implemented in the country. (AU)

• FAPESP's process: 11/21958-2 - Genetic resistance to HIV-1 in the salvage therapy with new antiretroviral drug classes
• Grantee: Luís Fernando de Macedo Brígido
• Support Opportunities: Regular Research Grants